Due caution on medical marijuana

For years, patients in Maryland with intractable pain, chronic diseases or terminal diseases have lobbied lawmakers to legalize the medical use of marijuana to ease their symptoms. And for years the state has been torn between compassion and caution about whether the purported benefits of medical marijuana outweigh the potential dangers of a drug that has not been subjected to rigorous scientific testing to determine its safety and effectiveness.

As a result, Maryland law on the issue has remained an inconsistent jumble. In 2003, the legislature approved a law allowing people charged with possession of small amounts of marijuana to claim "medical necessity" as a defense and, if they convince a judge their case has merit, to pay a $100 fine rather than go to jail. But even under that law a conviction still leaves patients with a criminal record, and, paradoxically, despite having proven their claim in court, it is still illegal for them to buy the drug.

Last week, Maryland moved a step closer to resolving that dilemma when Gov. Martin O'Malley withdrew his opposition to a bill that would allow doctors and nurses to dispense marijuana for medical use through academic medical research centers such as John Hopkins Hospital and the University of Maryland Medical Center. Mr. O'Malley refused to support medical marijuana legislation last year after Maryland Attorney General Douglas F. Gansler expressed concerns about possible liability for those who dispense the drug under federal law.

The governor reversed his previous stand this year after seeing that the U.S. Department of Justice, while prosecuting some medical marijuana cases in other states, had not been going after state government workers who were involved in the programs. Now the O'Malley administration is backing a bill that would give Maryland the strictest medical marijuana law in the nation, and it is insisting that the bill must give the governor the flexibility to suspend the program if the federal government threatened legal action.

The approach was shaped in large part by state health secretary Joshua M. Sharfstein, who last year suggested the idea of a research-based medical marijuana system to allow the state to gather more clinical data on the drug's usefulness. Dr. Sharfstein has opposed broader legalization efforts on the grounds that marijuana's medical efficacy remained unproven.

We think the go-slow approach endorsed by Dr. Sharfstein is a reasonable compromise between those who oppose any legalization of marijuana for medical use and those who want to see a total decriminalization of the drug.

Maryland certainly has learned from the experience of California, which legalized marijuana for medical use in 1996 and immediately saw a proliferation of lightly regulated head shops spring up to sell the drug, along with cadres of physicians willing to prescribe it on the flimsiest of pretexts. The state later amended the law in 2003 by issuing more restrictive guidelines regarding the kinds of illnesses for which medical marijuana could legally be sold and used after it became clear that many people were abusing the drug for purely recreational purposes. Given the controls built into the Maryland bill, however, that is unlikely to be a concern here.

Indeed, the legislation, sponsored by Baltimore Democrat Del. Dan K. Morhaim, who is also a physician, has come under fire not just from law-enforcement groups that oppose any legalization of marijuana but also from advocates who claim that it doesn't go far enough or fast enough to help people suffering from severe chronic pain. Delegate Morhaim, who has been a driving force behind the push for medical marijuana in this state, was also a sponsor of a bill that would have created a much more wide-ranging program.

But he has wisely recognized the value of the administration's support and is withdrawing his other bill. Other advocates in the legislature should follow suit. The governor's backing greatly increases the chances that those who are legitimately suffering and can benefit from the drug will finally be able to get it without risking jail time. And if Maryland's program provides rigorous, scientific data on the drug's effectiveness, this cautious step could set the stage for greater acceptance nationwide.

I think it should be a person's own choice to do whatever drug a person chooses as long as it doesn't involve committing a crime to acquire the drug. When it comes to marijuana, we should be able to have and smoke as much as we like ("Fixing Md.'s marijuana law," Oct. 3).

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